International Journal of Advanced Research in Medicine
2021, Vol. 3, Issue 1, Part D
Assessment of LV function after revascularization in patients of CAD with severe LV Dysfunction: A prospective study
Author(s): Dr. Karthik N and Dr. Prashant S Sidmal
Introduction: The “awakening” of a contractile myocardium after restoration of blood flow referred to as hibernating myocardium has generated considerable interest with regard to survival advantage following revascularization. Thus, before embarking on revascularization in patients with severe LV dysfunction, it is important to carefully assess presence and extent of viable myocardium.
Material and Methods: This is prospective and descriptive study conducted at tertiary care teaching hospital over a period of 1 year. The patients with coronary artery disease and severe LV dysfunction (with EF <35%) underwent nuclear scan (rest gated MIBI) to assess viability. Those patients in whom viability was detected underwent revascularization procedure either PTCA or CABG. The choice of revascularization was dependent on the nature of lesions.
Results: At baseline mean EF was 29.24±2.94, wall motion score index was 1.91 ±0.19 Out of 37, 24 had CABG (64%) and only 13 (36 %) patients had PTCA. Mean EF improved from 29.2% from baseline to 31% after 1 month (p=NS). At the end of 6 months EF improved to 34.9% (p<0.01) and after 12 months improved to 38%, again p<0.01. Similarly, WMSI improved from 1.91 from baseline to 1.87 at the end of 6 months (p=NS) and 1.76 at the end of 6months (p<0.01). After 12 months WMSI improved further to 1.67 (p<0.01). PA pressure improvement was non-significant at 1, 6 and 12 months. At baseline 8 had moderate MR, but the end of 1month only 7 were found to have moderate MR. At the end 6 months 2 had moderate MR, but none after 12 months. At baseline 16 had mild MR, at one month 17 and after 6months 16 had mild MR. At the end of 12 months 12 were found to have mild MR. Overall improvement in MR was not found to be significant.
Conclusion: Revascularization in patients with severe LV dysfunction and viable myocardium resulted in improvement in EF and WMSI at 6 and 12 months follow up.
Dr. Karthik N, Dr. Prashant S Sidmal. Assessment of LV function after revascularization in patients of CAD with severe LV Dysfunction: A prospective study. Int J Adv Res Med 2021;3(1):209-213. DOI: 10.22271/27069567.2021.v3.i1d.139